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Home My WebLink AboutPermit Miscellaneous 1984-09-266ltr--!- H.O. APPROVAL Zone Change Cond. Use Permit Greenway Dev. Permit Temporary Use Permit Special Use Permlt PLANNING COMMISSION LANE COUNTY GENERAL LAND USE APPLICATION DIRECTOR APPROVAL Partition: Subdivision: Cluster Subdivision: FILE NO Prel iminary Final Preliminary Flnal V variance' Site Review Preliminary Finallcto,t3J-to(.O Request for Interpretation Plan Amendment COMBINATION FEE (Applicantrs option-highest "aaitio"af "ppfi."tlon) . DATE SUBMITTED DATE RECEIVED Special Exception Hazard Check List _Site Investigation Report _Special Use Permi-t Planned Unit Devel Preliminary Final fee plus $25.00 for each opment: I. APPLICANT AND OI^]NERSHIP IDENTIFICATION 1. Name of Applicant n)Phone 741 - <7 7?- Mailing Address / i 7 -t 5, 'Z 1 Spnrt,, srL 1/ plE , 77 streer T- ciiy- Legal l"!e_r_12! - TitlehoJf'"#!rya&gntract Purchaser- Lessee- Other zip " a )L- A 2 3. Signqlu1qs I (rue) have completed all the attached application requirements and certify thar all statements are true and accurate to the best of my (our) knowledge and belief. I (we) am also authorized to submit this application as evidenced by the signature of the owner below. 0r^mer t s Signature a Agent's Signature Agent I s Address t5 <)G 5+, NL Date Date 5"/'c/gr{ 3 Phone LL p_ II. PROPERTY LOCATION Assessort s Map a Tax Lo Tax CodeS ize Pr:operty Address Road SEatus - StaEe County Rd. /- Y"alic Rd. Easement Abutting Property owned l/t-lU (acreage ) Map Tax Lot(s) Present Use h,Present Zon Structures /4/r--L I ,k l^iater Supply - Public___Onsite Wells-_Community Water Sy stem If Community Water S please list name Sewage Public Syst list name)__ Community Syst em ist name) ystem, "^wl(t Irrd ua1 Ons i te PUBLI C WORKS DEPARTMENT' COURTHOUSE.PSB I25 E 8TH c - 98-239 LAND MANAGEMENT DI VISION AVE. EUGENE, OREGON 97AOI FEE PAID / /4oo.@ f* i 6D!r-- H.O. APPROVAL Zone Change Cond. Use Permit Greenway Dev. Permit Temporary Use Permit Special Use Permit PLANNING COMMISSION LANE COUNTY GENERAL LAND USE APPLICATION Si Dp FILE NO DIRECTOR APPROVAL Partition: Preliminary Final __Subdivision ; Preliminary Flnal Cluster Subdivision: Preliminary Final k' variance <i..:':). t 35 - t '\ ('i) -situ Review Special Exception Hazard Check List te Investigation Report ecial Use Permit Request for Interpretation Plan Amendment FEE PAID COMBINATION FEE pplicant's option-highest fee plus 925.00 for each additional application) . DATE SUBMITTED DATE RECEIVED -_----:_- I. APPLICANT AND OWNERSHIP IDENTIFICATION 1 Name of Applicant Phone Mailing Address z b 77 Sfreet City zip 2 !"g=]-].,!e-!9.:sl._Tit1.eho1der----ContractPurchaser-Lessee- Other Planned Unit Development: Preliminary Final 3. Signatures I (rve) have completed all the attached application requirements and certify that all statements are true and accurate to the best of my (our) knowledge and belief. I (lve) am also authorized to submit this application as evidenced by the signature of the owner below r 0vrner t s Signature 1. '-.) Date_ Agent's Signature f+r/ rrAr{, a Date NL PhoneAgent t s Address II. PROPERTY LOCATION Assessorts Map I I .77 /4oo I Tax Lo Tax CodeSize Property Address Road Status - State Co untv Rd. V Pub1ic Rd. ,lln-tLr" ,fi Easement Abutting Property Owned (acreage) Map Tax Lot (s) Present Use S t ruc tu res Present Zoniu# Water Supply - Public onsite hlells __Community Water Sy stem t name Ind ua1 Onsite If Cornmunity Water System, please lis Sewage - Public system-ffilisL name) Community System I (list name) I PUBLIC WORKS DEPARTMENT, LAND MANAGEMENT DIVISION COURTHOUSE.PSB t25 E 8TH Av,E. EUGENE, OREGON 9740I c- 98-239 t*E;t) t 't-\ T/fJ tr {*q /flr')X ?-Dfr ,- Z1 7 , {DA,f - -a e.4u 'L{t r /r, -. t/ , / t r a -, F t-tt Y T'HI r.l l.t $R .t lll / ,) F-' T t, t- {tli